Fitting in on the floor

[amarilla, RN]

Hi all,

this is the first thread I've posted on AN, so kindly bear with me as I try to ask my question as plainly as possible...

how did you learn to get along on your floor as a new nurse, (whether new grad or new hire)? How to manage to get your work done as well as cover your butt for those busy body types watching over your shoulder? How to advocate for yourself without appearing argumentative or defensive? How to avoid this "UGH" feeling that this type of lateral nonsense creates, usually the night before the inevitable workday?

This is my second career; I'm 30, licensed five months as a RN and working four months now on a busy med-surg floor at a teaching hospital. I worked the same floor as a nurse tech and chose this floor as my first choice when I applied as a new grad to our hospital system for a RN position. Despite having an attractive choice or two, I accepted this position because I knew the floor, the staff and really liked the expansive range of skills available with the diverse patient population we see.

I've been on my own for nearly two months and feel good most days, terrible on a few others. I imagine that's natural. I was hired for nights and was thankfully finding my own comfort level and routine; unfortunately, two people came back recently, (one from maternity, one from disability leave), and I've now been shifted back to days. I worked with most everyone as a tech, so I'm fairly comfortable with that. I've received good feedback from peers and felt that work on days was going fairly well...

until another nurse told me that there have been a couple people who have complained about me. In one instance, a unit secretary was upset that I didn't go to a patient's room who was having diarrhea, (I was in a room settling my new admission, and asked her to call the patient's nurse or tech to the room while I was busy.) She had yelled at me when I came back to the station that 'it's not her job to do care, and it's (all nurses') job to do care.' I responded to ask her not to yell in front of our coworkers and visitors, and that we could continue the conversation somewhere less public if she wished. I got the silent treatment the remainder of the day and I guess she complained to other nurses who weren't even working that day.

Another: that a nurse said I didn't label my IV tubing, (could totally have happened, I admit.) This is the same nurse who, every time I have taken her patients on the following shift, has left me orders undone and meds (heparin drip, abx, PCA refill), not given. *sigh.

I feel badly, because I don't want to fight with people. I just want to do my job. I like suggestions and always try to improve, (you can bet I label everything now!), but the behind-your-back stuff makes me feel uncomfortable. How do I know that the nurse I ask an honest question to isn't turning around to others about how stupid I am for not knowing how to hang ____? Or, if I snip off arguments in progress, (see unit secretary above), is this really being seen as being too confrontational?

I worked a very stressful corporate job prior to this, and I'm not unfamiliar with office warfare. I lasted ten years in a cutthroat environment, and thrived well enough. Hospital warfare, however, is new to me and I'd like to know how to survive. Any tips?

Thank you in advance for any help, AN friends.

[jpeters84]

I have only worked as a nurse aide, not as an RN yet, but I was so relieved to read your post because I have had very similar experiences working in the hospital as you. I to am 30 years old, this is a second career for me, and I was not expecting the pettiness and behind the back complaining that I have encountered. It makes the jobs unbearable sometimes.

When did it become ok for nurses or nurse aides, or unit clerks to go behind each others backs and complain? If you have a problem go to the person and talk it out like adult professionals. I even had a nurse manager call me in to their office to talk about a patient complaint over a minor incident that happened 6 months ago and she couldn't believe that I couldn't remember all the details. Its like give me a fair chance here.

I felt like I was always having to watch my back and in the end stopped worrying about befriending everyone and just kept to myself because that seemed safer. I hope this hostile work environment that seems to have become so endemic in nursing stops soon and I truly hope that it isn't everywhere. While I was relieved I wasn't the only one who has had these experiences I thought they were happening maybe because I was a nurse aide but I guess not. Hang in there. Hopefully as you gain more confidence and are no longer the newbie things will get better.

[sunnycalifRN]

You can never make everyone happy in nursing. Either docs, family, the patient or your co-workers will at one time or another have some complaint about you. You're only human, you do the best you can. Unfortunately, there are always insecure people out there who have to put others down, I guess to make themselves feel superior. Do what I do, I just ignore them.

[Been there,done that, ASN, RN]

Unfortunately, you are viewed as a newbie. In some areas,with some nurses, this gives them an arena to vent their personal frustrations.

I have been in this situation MANY times (note my user name). It sounds like you are in a large institution.

This kind of behavior is the norm. PPLZ!! Unit clerks yelling at you, the professional???

I see it as a no win.. management will NOT help, seek employment where you are appreciated.

Best wishes.

[MassED, BSN, RN]

I have moved quite a bit and since being a nurse, have worked in 4 different hospitals. In this profession, women seem to want to "test" out the new gal. Some alpha females want to test more than others. They are insecure and are trying to show you who's boss. I have dealt with this time and time again. It's stupid and a total waste of time, but they are insecure and are fearful of a smart person coming in to throw them off of their position. Women are so competitive, it's ridiculous.

I'm in a new job currently and I am dealing with variations of this myself. Many nurses believe they are the hot shot nurses, so to appease them, I usually smile, nod, and walk away. Other times, I engage them in something non-nursing just to shut them up. I have been in an ER for going on 7 years, but I have newer nurses (to the ER) try to interject their opinions on how I should do things constantly - without my ever asking. Often times I respond, but many times it's just too exhausting to play along with their antics and I just walk away. Other times I'll tell them this is how it's done and how I've done this for years and it's no different now than it was back then.... Some people just want to be perceived as the smartest, most knowledgeable nurse and nothing you say or do will back them off of you. Eventually it will get better. I find that standing your ground works. It's like standing up to a bully at the playground. That nurse that leaves a mess for you, you need to write her up. If she's writing you up (and I'll bet she is), then don't take it lying down. Who cares if no one likes you but YOU, that's all that matters. Do a great job (and it sounds like you are) and let the other chips fall where they may. I'm sure there are others there who know the trouble makers that are trying to mess with you and who will vouch for you as well. Good luck, I feel for you and I know how it goes - I wish women weren't so catty, petty, and insecure. Try to rise above it.

[noahsmama]

So, did the nurse who said that you didn't label your IV tubing tell you directly, or did she tell another nurse who then told you? If she told you directly, I would have thanked her for pointing it out. If she didn't tell you directly, I would go to her the next chance you get, and in a friendly, non-confrontational way, say, "hey, nurse so-and-so told me that you noticed that I didn't label my pt's IV tubing the other day. Just wanted you to know that I really appreciate feedback like that and I'm now being extra careful to label all my tubing. If you notice anything else like that, please come to me directly about it".

As for the unit secretary, do I understand correctly that she wanted you to go take care of a pt having diarrhea who wasn't even your pt, and you were busy with one of your own pts? And you asked her to call the pt's nurse or tech to the room? Heck, that's just asking her to do her job! Unfortunately, you cannot SAY to her "I was just asking you to do your job" -- that will only make it worse. So, I might do what another poster suggested and just ignore the fact that she's mad at you. If you continue to have problems with her, are there any other nurses you work with who have been there longer than you that you get along with particularly well? If so, maybe you could ask them if they've had problems with the unit secretary, and how do they deal with it?

And, by the way, if you've gotten positive feedback from your peers, then work IS going well. You can't please 100% of the people 100% of the time -- sounds like you're doing pretty well in keeping most of them happy. And of course, the most important question is, are you giving your pts the care that they need? If you can answer "yes" to that question, then you're doing you job! Don't let the naysayers get you down!

[amarilla, RN]

Thank you all so much for your replies, kind words and advice! :hug:

To answer a few questions:

I don't know that anyone has written me up, and neither of the people who complained to this other nurse approached me directly. I would hope that someone with a concern or suggestion does approach me; I'm learning so much and appreciate anything more I can get from more experienced nurses.

Yes - the unit secretary was paging me about another nurse's patient while I was with one of my own. I am happy to help anyone and frequently do the extra when situations present, (roommate's IV beeping, pt needing extra blanket or help setting up dinner tray, etc), but I was busy with a new admission just back from PACU. As one of you mentioned, I feel that patient care involves everyone - regardless of who is assigned - but I do feel that my patients come first unless something is emergent or has potential for imminent harm, (pt about to fall, for example.)

I realized that staying on this floor - from tech to RN - was going to be an adjustment, but I didn't expect the backbiting from people I thought were decent. *oy*. I just want to do right by my patients and learn to be a better nurse!

I will definitely try to engage politely, take what I can use and toss the rest. I just worry, being new, that snarky grievances will affect my job status. I'm only per diem and don't want a tussle over shifts because people don't want to play nice. I have hope, thanks to you all, that this will get better as I gain experience on the floor and have a few battle scars.

Hugs all who replied and to those experiencing the same!

[himilayaneyes]

Unfortunately, you can't make everyone happy so don't try to. Nursing is like any other job where there will be some people you live and some you avoid like the plague. Just do your best, ask questions, utilize your resources (charge nurse, policy and procedures manual, etc.). As far as the nurse leaving things not done, that heparin drip....sounds like an incident report to me. Heparin is a dangerous drug and it's all about patient safety...that medication if done incorrectly definitely deserves a write up. Be yourself and let people accept or reject you. If they reject you, it's their loss...not yours.

[enchantmentdis, BSN, RN]

These are petty things that the others are complaining about. Don't let them trip you up. Sounds like the typical territorial behavior of nurses, which is unfortunate, but very familiar to anyone who has been a nurse for a few years. Nurses also have their cliques and it takes awhile to become a part of the group, sad for you since you've already known these folks in your previous job capacity. Sounds like some have sour grapes over the fact that you are a registered nurse now and they are not. No need to remind them that all they have to do is go back to school just like you did.The green-eyed monster strikes again! :lol2:

[enchantmentdis, BSN, RN]

You won't have this problem so much if you take up hospice or home health nursing; in these careers you will be in your car all day driving to people's homes or to facilities and will be working for the most part independently. And hospice and home health often hire new grads or inexperienced nurses. I am so grateful to have a hospice case management position--could no longer tolerate the heart-breaking back-biting, cut-throat, down-right cruel behavior of fellow nurses in acute care. Being trapped for twelve, ten, or even eight hours on the same floor with the same annoying & needy patients, intrusive family members, micro-managing administration, egomaniacal physicians, hapless interns, and unhappy subserviant ancillaries has left me with zero tolerance for hospital nursing and a low morale in general. Thank God for hospice nursing.

[Kooky Korky, BSN, RN]

Why was the clerk paging you about someone else's patient?

The clerk does not determine priorities. You do. You're the nurse. She's just shocked at being put in her place by a (former) tech. I think you handled her absolutely beautifully.

Not taping your tubing? I know the world came to an end for that horrendous error. Yes, you need to do it. My problem, though, is why the catty B***H who c/o behind your back didn't just tell you to your face. That's one of MY chief gripes - they talk nice to our faces then stab us in the back. Either hateful intentionally or afraid to just tell you openly.

I know it's easier said than done, but try not to give any thought to these nincompoop coworkers. Do defend against them, do pray for them to become your friends, and do ask them what I have asked - why not just tell me to my face? Are you trying to get me in trouble or what?

Sadly, the reality is that you have to deal with them. And your corporate background success makes you quite capable. Also, the less you say directly to them or, God forbid, about them to others, the better.

Consider writing up or at least reporting any med errors you find, although that could be like waving a red cape at a bull. But it sounds like some nurse you follow has either not given or not charted her meds - very possibly dangerous, definitely error.

I know it's unpleasant, but you're dealing just fine with the cr*p, I think.

[Kooky Korky, BSN, RN]

Unfortunately, you can't make everyone happy so don't try to. Nursing is like any other job where there will be some people you live and some you avoid like the plague. Just do your best, ask questions, utilize your resources (charge nurse, policy and procedures manual, etc.). As far as the nurse leaving things not done, that heparin drip....sounds like an incident report to me. Heparin is a dangerous drug and it's all about patient safety...that medication if done incorrectly definitely deserves a write up. Be yourself and let people accept or reject you. If they reject you, it's their loss...not yours.

Trouble is, it could very well be her loss if they attack her, gang up on her, single her out to "get" her.